Periungual fibromas usually seen in the context of tuberous sclerosis. They arise from the nail folds and usually appear in late childhood. However, sporadic cases of fibromas may occur in persons without tuberous sclerosis as in the presented case of a young adult lady with one year history of a digitate growth originated in the proximal nail plate and extended to the nail plate surface resulted in a longitudinal groove.
A 60-year-old woman presented with a solitary, asymptomatic, pinkish, oval nodule emerging from the base of the nail of the big toe of two years duration. The patient had no features of tuberous sclerosis.
This 57-year-old man presented with asymptomatic, bilateral symmetrical, infiltrative, purplish plaques involved both lower legs of 10-12 months duration. He had no lymph node involvement or distant metastasis. HIV antibody was negative and skin biopsy has confirmed the diagnosis of KS.
A 67-year-old woman who is a known case of neurofibromatosis since early childhood presented with myriads of skin-colored soft nodules involving most of the face and many other parts of the body. The face mimicked a “bunch of grape“due to these tumors. The nodules were soft and can be pushed down into the panniculus by light pressure with the finger (“buttonholing”) and spring back when released. Biopsy proved that these tumors are neurofibromas.
An 83-year-old woman with an atrophic bald scalp started to develop many red patches with peripheral black dotty pigmentation of more than one year duration. Later on many ulcers arose within these patches. The biggest ulcer was at the parietal area of the scalp. This ulcer was covered with heaped up friable and hemorrhogic crusty material. Many firm to hard non tender lymph nodes were palpated in the head and neck region. The strange and interesting thing in this case was the lesions clinically start as pigmented BCC and later on they took a SCC-like morphology. Histopathology of many biopsies (early and late lesions) showed basisquamous cell carcinoma.
A 78-year-old man presented with an asymptomatic, irregularly-shaped rodent ulcer with a slightly-pigmented rolled up border involved the upper lip of 5 years duration. Incisional biopsy revealed nodulo-ulcerative BCC.
This unfortunate young female suffered multiple, asymptomatic, flesh-colored, translucent, firm papules involving the center of the face especially the melolabial folds. These lesions first appeared at early childhood and continued to increase in number with time. One of her brothers also has had similar lesions. Skin biopsy showed trichoepithelioma.
